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The bacterium Neisseria gonorrhoeae (gonococcus), which causes gonorrhoea, can be transmitted by various forms of sexual contact, including vaginal, oral, and anal sex. The infection is usually confined to the site where the bacteria enter the body, such as the vagina or the mouth, but can spread through the bloodstream to other parts of the body. A baby who is exposed to the infection in the birth canal during delivery may develop neonatal ophthalmia, a severe eye infection that can cause blindness.

In the UK, the incidence of gonorrhoea has been falling since 2002, with about 16,600 new cases of the disease in 2008. It is more common in young adults, although it can affect sexually active people of any age, and males are more commonly affected than females.

What are the symptoms?

Gonorrhoea often causes no symptoms. If symptoms occur, they usually appear 1–14 days after sex with an infected person. In men, they may include:

Discharge of pus from the penis.

Pain on passing urine.

Without treatment, the symptoms may start to disappear after about 2 weeks, but the person remains infectious.

About 1 in 2 infected women has symptoms, which may include:

Yellowish-green discharge of pus from the vagina.

Pain on passing urine.

Lower abdominal pain.

Irregular vaginal bleeding.

In both sexes, if gonorrhoea occurs as a result of anal intercourse, the anus and the rectum may become inflamed (see Proctitis), but usually there are no symptoms. If the infection has been transmitted during oral sex, the first symptom may be a sore throat.

Are there complications?

Gonorrhoea in men can lead to inflammation of the testes and epididymides (the tubes that carry sperm from the testes), a condition called epididymo-orchitis. Gonorrhoea may also result in inflammation of the prostate gland (see Prostatitis) or of the bladder (see Cystitis). Rarely, the disorder results in urethral stricture, scarring and blockage of the urethra (the tube from the bladder) that causes difficulty in passing urine.

What might be done?

If you suspect that you or your partner has gonorrhoea, go to a clinic specializing in STIs or to your doctor. To confirm the diagnosis, a swab will be taken from areas that are likely to be infected and tested for the bacteria. You will also have tests for other STIs, such as chlamydial infection. Gonorrhoea is treated with antibiotics and usually clears up in 3–4 days. If bacteria have spread throughout the body, treatment with intravenous antibiotics in hospital is necessary. All sexual partners should be tested and offered treatment.

Cells infected by gonorrhoea bacteria

The vaginal cells in this image have been infected by Neisseria gonorrhoeae, the bacterium that causes gonorrhoea.

Can it be prevented?

You can take steps to reduce your risk of contracting gonorrhoea (see Preventing STIs). If you are infected, avoid sex until you and your partner have finished treatment and your doctor says that you are free of infection.